WORD: WOrd Retrieval & Development
Wendy Best & Lucy Hughes
CSLIR November 2012,
Division of Psychology and Language Sciences, UCL
Co-PI s Professor Jackie Masterson, Institute of Education
Professor Michael Thomas, Birkbeck College
Outline
Short Background – word finding & intervention
WORD (2011-2014)
– Strand 1: Primary data collection (IoE & UCL) – new tasks
– Strand 2: Computational modelling of typical
& atypical naming development & intervention (Bbk)
– Strand 3: Intervention (UCL & IoE)
Design
Preliminary findings
KEY-PHONE (1988 -2005 +)
- Brief outline of findings & availability
Word-finding difficulties in children
• “I was about to say porcupine, um what is it.., not
apple juice, oh.. the fruit with the funky hairdo”
Marie
• Target Pineapple
Word-finding difficulties
• Occur in ¼ of children attending language support
services (Dockrell et al.,1998)
• Often occur in the context of wider specific language
needs, particularly in expressive language
• But, can also occur as a specific difficulty without SLI
and can occur with other learning needs (Best, 2005)
• Are likely to have different sources in different
children (e.g. Constable et al.,1997: McGregor and
Waxman, 1998, Bragard et al., 2012)
Word-finding –in your vocabulary
/tip-of-the tongue?
Related research: intervention for word-finding
problems in children
• Hyde-Wright et al. (1993) 8 to 14 years
• Wing (1990) 6-7 years
• Each study had 2 groups of children:
semantic therapy and phonological therapy
Related research
Therapy type
Semantic
Phonological
Hyde-Wright et al.
Improvement
No change
Wing
No change
Improvement
Ebbels et al., 2012 note 4/5 children who received semantic
intervention in Wing et al study did make progress
Overview of word-finding intervention research
with children.
Despite methodological concerns and conflict over the relative
effectiveness of phonological and semantic approaches,
overall:
– intervention can improve word-finding abilities in children
– this can occur over a wide age range (Wing 1990, Hyde
Wright et al., 1993)
– a narrative approach may be effective (Marks and Stokes,
2010)
– effects can generalise to untreated words (Ebbels et al.,
2012, Hyde Wright 1993)
– changes in word-finding in discourse can accompany item
specific therapy effects (Best, 2005)
– the effects can maintain (e.g. McGregor, 1994, Bragard et
al., 2012)
WORD Project
100 typically developing children, 3:7-8:6 years
30 children with WFD, 6-8 years.
•
All children:
– Naming (accuracy, RT, errors)
– Knowing tasks (word picture verification WPVT),
– Semantic task (NEW PJs),
– Non-word repetition (CN Rep)
•
Clinical population, as above and:
– Test of Word Finding
– Test of Word Finding in Discourse
– Clinical Evaluation of Language Fundamentals (R) - 4 ,
– Auditory discrimination (TAPS)
– PhAB subtests
– British Picture Vocabulary Scale,
– Reading
– Pattern construction (WISC-IV-UK)
Primary data collection
VERY preliminary findings
Age and Naming
70
Naming (accuracy/72)
60
50
40
30
20
10
0
0
20
40
60
Age (months)
80
100
120
WPVT (NB after naming)
‘Quokka ?’
WPVT (NB after naming)
‘Wombat ?’
Primary data collection
VERY preliminary findings
Naming and WPVT
70
WPVT (Combined)
60
50
40
30
20
10
0
0
10
20
30
40
Naming (accuracy/72)
50
60
70
Picture Judgement (PJ)
Task: Practice item 1
Picture Judgement (PJ)
Task: Example item
Intervention strand of WORD
•
Needed to determine form of interventions…
– Elaboration (word webs) vs retrieval (cues+)
– Single lexical items vs items in context
– Semantic versus phonological (Clinical Advisory Group)
•
Each intervention once a week, 30 minutes, for 6
weeks
Semantic Intervention
• ‘Semantic Feature Analysis’ literature (e.g.
Boyle & Coelho 1995; Massaro & Tompkins,
1994) with adults with aphasia.
• Some weak evidence for generalisation to
untreated items in adult literature.
Semantic
intervention
Phonological Intervention
• Mirror of semantic intervention
• Adult ‘Phonological Components Analysis’
literature ( e.g. Leonard et al, 2008), emphasis on
active participation in contrast with phonological
approaches involving simply being provided with
form
• Can wonder at premise – if word form can not be
retrieved how can you access e.g. first sound?
• Include orthography
Phonological
therapy
Phonological therapy
Semantic & Phonological interventions
• Partially based on clinically-used ‘word-webs’,
‘walk the word’+ related approaches
• Impossible to separate completely, picture and
word form involved in both interventions
• Encourages active generation of semantic or
phonological information or choice between
related features
• Later sessions encourage awareness of what
helps own word-retrieval/production & involve
communication of target items (barrier games)
Design of intervention study
• Each child participates in two interventions:
–
–
–
–
–
Baseline phase
Intervention 1
Wash-out phase
Intervention 2
Maintenance phase
• Random assignment:
– Items – 4 sets, different for each child (matched for baseline naming
and psycholinguistic variables)
– Do not select items that are difficult to name (avoid regression to
mean)
– Delay/ Immediate - RCT comparison @ post-therapy 1
– Phonological then Semantic or Semantic then Phonological
Child-specific items
Curriculum-based examples
Extra-curricular examples
Recycle
Sycorax
Extinct
Regeneration
Spring
Usain Bolt
Divided by
Natasha Kaplinski
Quarter
Trifle
Settlement
Kids’ Club
Stem
Connect 4
Intervention strand
• Blind assessment (double blind not possible),
• Probes during intervention,
• Treatment fidelity (& able to look at during
intervention in detail)
• Primary outcome measure – picture naming
• Language assessments, control tasks, children's
parents’ and teachers’ views
• Analyse outcome both for group and case series
Background information
Amy
Comprehension good relative to expressive language
Keen story-teller
Relatively better able to find words in conversation than
picture naming
Magda
Receptive and expressive language needs
Keen to communicate
More severe WFD, uses gesture, to help get her
message across when she is stuck
Naming probes
Targets &
1.Chilli
2.Brush
3.King
4.Yacht
5.Stamp
6.Wheel
7.Triangle
responses
no response
correct
queen
boat
no response
correct
rectangle
Pre-therapy assessments:
Amy (7:06)
Magda (7:08)
CELF: (scaled score)
Concepts & Directions
11
3
CELF: (standard score
(percentile))
Core language
81 (10)
60 (0.4)
95 (37)
87 (20)
PhAB: Fluency test
Semantic (standard
(percentile))
111 (77)
77 (6)
Naming correct
(raw score, n= 72)
21
14
PhAB: Fluency Test
Alliteration (standard
(percentile))
IDWACLT01 Naming
25
Naming controls
15
Unseen controls
Semantic set
10
Phonological Set
5
Asessment
ai
nt
en
an
ce
M
Po
st
Se
m
W
as
h
ou
t
0
Pr
eth
er
ap
y
1
Pr
eth
er
ap
y
2
Pr
eth
er
ap
y
3
Po
st
Ph
on
Number correct
20
Messages from WORD
• Word picture verification (‘is it a?’) can be useful task
(fairly easy to construct in clinical setting)
• 2 experimentally controlled case studies suggest children
with different language profiles benefit differently from
semantic and phonological intervention
• The effects
–
–
–
–
are not due to regression to the mean
are not due to repeated attempts at naming
appear to maintain
appear specific to treated items and include those chosen by
children/parents/teachers
- arise from 6 sessions of intervention
The aid-> KeyPhone (available free on CSLIR
website under resources)
d
m
p
t
c
f
s
l
b
Task: naming pictures
The Children
Name
Rod
Shaun
Age
10:7
6:10
Language
Language
Education Resource Resource
SLI
Severe
Behaviour
Other
Language & Attention
+s
Sas
9:6
Becca Marie
9:5
8:10
Mainstream Language
with LSA
Resource
Bilingual
School
MLD
ADHD
Visuospatial tasks
Bilingual
English/
Spanish
Used
restricted
Literacy
Listening
language
Impairment
Hard to pinpoint
problem
Visual skills Communicative Not SLI
Conceptual
Drawing
Lively
Enthusiastic knowledge
Language
& wider
abilities
Intervention with aid
• 2 sets, intervention and control matched for baseline
naming
• Also set of items on which child/parent/teacher/clinician
wishes to work
• Once a week for 6 weeks
• Set protocol, steps vary across sessions
Results for case series:
Performance during intervention
Proportion correct
1.00
0.80
Rod
Shaun
Sas
Becca
AnneMarie
0.60
0.40
0.20
0.00
1
2
3
4
Therapy session
5
6
Naming Pre- & Post- Intervention
1
Key
0.8
I Pre
I Post
0.6
0.4
C Pre
C Post
0.2
0
1 Rod 2
3
4
Shaun
5Sas
Name
6
where
I=intervention
C=control
7
8 Anne-Marie
9
10
Becca
Pre=mean A1A2
Post=mean A3A4
Key-phone outcomes
– No significant change for any of the children on the
language control tasks: BPVS and sub-tests from the
CELF
– Significant improvement in naming therapy set, the size of
which did not differ across children (very large effect: for
group data Cohen’s d=2.995)
– No significant change for individuals on control items,
matched for baseline naming (for group Cohen’s d=1.0 &
significant change)
Key-phone outcomes cont…
– Significantly fewer semantic errors after
intervention (for 4/5 children, one close to floor at
start)
– The similarities suggests, despite very different
wider language and learning profiles, the
mechanism for change may be the same
– For 2 children, wider changes were found. There
was a significant reduction in W-F behaviours on
the TWFD (SSs Shaun 81->96, & Marie 64 ->88).
Key-Phone Conclusions
• An aid which turns letters to sounds can improve children’s
ability to retrieve a set of targeted words.
• The therapy is clinically applicable (in terms of population,
intensity and duration of intervention) within some speech
and language therapy services.
• Interventions devised for use with adults with aphasia may
be relevant for children with developmental language
impairments.
• The exchange of approaches can be bi-directional (Chiat et
al., 1997; Joffe et al., 2008).
Case series designs can be useful in providing evidence on
the effects of interventions.
Project Team
Wendy Best (UCL): principal investigator
Jackie Masterson (IoE): co-principal investigator
Michael Thomas (BBK): co-principal investigator
Lucy Hughes (UCL): speech & language therapist/research associate
Anna Fedor (BBK): postdoctoral researcher
Silvia Roncoli (IoE/BBK): PhD student
Anna K. Kapikian (IoE): research assistant
Liory Fern-Pollak (IoE): postdoctoral research officer
Contributors: Mike Coleman, Chris Donlan, Vivien Gibson, David Howard,
Caroline Newton, Merle Mahon, Jo Piper, Rachel Rees, Sarah Simpson,
Amelia Wong.
Thanks to all the children, parents, teachers, TAs, schools &
speech & language therapists who have contributed to WORD
Thank you
While there are a few small
colonies in southern Western
Australia, the quokka is now seen
most often on Rottnest Island off
Western Australia. They are small
solidly built wallabies, weighing
between 2 to 4kg and standing
30cm tall.